CN100588393C - Use of symipristone analog for treating depression - Google Patents
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- CN100588393C CN100588393C CN200410093036A CN200410093036A CN100588393C CN 100588393 C CN100588393 C CN 100588393C CN 200410093036 A CN200410093036 A CN 200410093036A CN 200410093036 A CN200410093036 A CN 200410093036A CN 100588393 C CN100588393 C CN 100588393C
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
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- A61P25/24—Antidepressants
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Abstract
The present invention relates to the use of Symipristone compound in prepared medicine for treating depression, especially serious depression and psychotic serious depression. The present invention also relates to one kind of medicine composition for treating depression, especially serious depression and psychotic serious depression.
Description
Invention field
The present invention relates to the pharmaceutical chemistry field, particularly, the present invention relates to the purposes that symipristone compound is used to prepare the medicine for the treatment of depression.
Background technology
Because the high speed development of modern economy and the remarkable enhancing of social pressure, rate of depression improves year by year, in in the past 10 years, depression has become one of prevailing in the world public health disease, the people is 10%-25% in the probability of suffering from depression in life, its severest consequences are to commit suiside, and are annual above 1,000,000 people.According to the numeral that psychosis association in the world's delivers, present global patients with depression every year, depression became " epidemic diseases of 21 century " with 113% rate of increase cumulative year after year.
Depression (Depression) is also referred to as depressive disorder (Depressive disorder), main clinical characteristics is remarkable and persistent depressed, showing as energy goes down, continue tired, the movable minimizing and hebetude (" depressive disorder diagnosis and treatment key ", chief editors such as Zhu Ziqing, version in 2003, P1).
The classification of depression can be divided by the order of severity of disease.The 10th edition (ICD-10 of International Classification of Diseases system in World Health Organization's establishment, 1992) in, just paralepsy is divided into slightly, moderate and severe, distinguish the severity (" depressive disorder diagnosis and treatment key " of getting involved according to the quantity that is the symptom appearance, type, subjective experience and social function, chief editors such as Zhu Ziqing, version in 2003, P40-P44).Major depression (Major depression) is also referred to as major depressive disorder (Major depressive disorder), be meant once or severe (principal characteristic) paralepsy and do not have maniac access, hypomania or mix the depressive disorder (" Clinics and Practices of depressive disorder " of outbreak repeatedly, Yang Quan writes, version in 2003, P152).
Psychotic disease major depression (Psychotic major depress ion) is also referred to as psychotic depression (Psychotic depression), and a special subgroup that is major depression is (in making tranquil " foreign medical science psychiatry fascicle ", 2000; V27, P215), i.e. before the feeling the pulse with the finger-tip or the last severe (principal characteristic) paralepsy spiritedness characteristic of disease symptom such as hallucination or/and vain hope (" Clinics and Practices of depressive disorder ", Yang Quan writes, version in 2003, P38).
Pathogenesis about depression, classical " monoamine hypothesis " thinks that the generation of depression is lowly relevant with interior 5-hydroxy tryptamine (5-HT) of brain and/or norepinephrine (NE) level, but can not explain why realistic problem (the Zhu Xing family of delayed onset of anti-depression drug, Luo Zhipu etc., " neuro pharmacology is newly discussed ", P1).Scientists finds that by secular observation and research cortisone (hydrocortisone) secretion of most of depressive patients increases.Cushing's syndrome (because of the hypothalmus-pituitary-adrenal axis functional lesion, a kind of endocrinopathy that the glucocorticoid secretion imbalance is caused) patient suffers from the ratio of depression apparently higher than normal population.Discover that depression (particularly major depression) is hyperfunction with cortisol secretion relevant with hypothalmus-pituitary-adrenal axis (hpa axis) dysfunction.
Depression with the evidence that cortisol levels (glucocorticoid level) rising is associated is: the cerebrospinal fluid of (1) depressive patients, blood plasma and urocortisol raise; (2) with dexamethasone can not suppress the blood cortisol levels (Krishnan KR etc., Psychiat.Clin.North.Am.1998, Vol.21:465).
Human cortisone (hydrocortisone) secretion can be suppressed by corticosteroid such as dexamethasone (Dexamethasone), and dexamethasone suppression test (DST) is to measure the sensitive indicator of hpa axis to exogenous hydrocortisone feedback suppression.As take dexamethasone and can not suppress cortisol secretion (DST test positive) testee's hpa axis hyperkinesia is described, the DST positive rate of depressive patients is about 40-50%, and the false positive rate of normal person DST only be 4%-10% (Wang Xueming etc. " spirit with psychotic biochemistry ", 2000, P368), illustrate that thus a lot of patients with depression because of the hpa axis feedback function suffers damage, cause cortisol secretion to continue to increase.
The cortisone that it is found that dexamethasone suppression test (DST) does not under study for action suppress degree and is associated with depressed severity, major depression patient DST positive rate is 50%-70% (" a depressive disorder diagnosis and treatment key ", chief editors such as Zhu Ziqing, version in 2003, P67), be higher than depressive patients (about 40%-50%).And in major depression, the psychotic disease major depression is not to be suppressed the closest a kind of hypotype of relation (in making tranquil " foreign medical science psychiatry fascicle ", 2000 with the DST cortisone; V27, P216), above situation prompting major depression particularly psychotic disease major depression is hyperfunction more tight with the handicapped relation of hpa axis with cortisol secretion.
Human body inner cortex alcohol (glucocorticoid) concentration continues to raise and can produce a series of biological effects.Its influence to neurotransmitter comprises: 1. reduce the 5-hydroxy tryptamine energy; 2. reduce norepinephrine energy; 3. dopamine (DA) energy raises.Endocrine influence is comprised: 1. increase the secretion of corpus amygdaloideum thyroliberin (CRH); 2. suppress hypothalamic-pituitary-thyroid axis; 3. suppress hypothalamic pituitary gonadal axis; 4. increase the secretion of growth hormone (GH); 5. blood glucose raises.More than a series of variations be the major reason that causes depression (analogy Dongshan. Chinese behavioral medicine science, 2000, V9 (4), P317).
At the phenomenon that patients with depression hpa axis negative feedback function suffers damage, cortisol secretion continues rising, consider that particularly hpa axis negative feedback function is subjected to the glucocorticoid receptor (GR) mediation, scientists attempts treating particularly psychotic disease major depression of major depression with glucocorticoid receptor antagonists, has obtained excellent curative.
Mifepristone (Mifepristone, RU 486) is that it and glucocorticoid receptor (GR) have high affinity by a glucocorticoid receptor antagonists of French Russell-You Kerafyrm company exploitation, and it is (right that the Antiglucocorticoid effect detects
3H-TdR mix In vitro culture rat chest cell DNA influence test and mouse thymus degradation experiment) show that mifepristone has the Antiglucocorticoid activity, show that it is the glucocorticoid antagonist of acceptor levels.1993, Murphy etc. with the exploratory clinical trial of mifepristone treatment major depression achieve success (Journal ofPsychiatry Neuroscience, 1993, V18:P209).In recent years, Belanoff and Schatzberg etc. has also carried out repeatedly clinical trial, with mifepristone treatment psychotic disease major depression and achieve success (Journal of Clinical Psychopgarmacology 2001, V21, P516; BiologicalPsychiatry.2002, Vol 52 (5), P381).Above-mentioned evidence with the glucocorticoid receptor antagonists treatment major depression effectiveness of psychotic disease major depression particularly.In the single test therein, 30 routine psychotic disease major depression patients are divided into three dosage groups, be respectively 1200mg/ days, 600mg/ days and 50mg/ days, took mifepristone continuously 7 days, wherein 1200mg is similar with 600mg group effect, and effective percentage is more than 60%, the effect that is equivalent to existing medicine, and have the slight characteristics of rapid-action (a week in), side reaction (Biological Psychiatry.2002, Vol 52 (5), P381); And the onset time of existing medicine reached for 2～4 weeks, and had than significant side effects.
It is generally acknowledged, treatment such as glucocorticoid receptor antagonists such as mifepristone depression effective mechanism mainly is: (1) causes the compensatory rising of glucocorticoid receptor (GR) quantity because Antiglucocorticoid is active, cause the degenerative enhancing of hpa axis, and it is normal to make it functional rehabilitation; (2) glucocorticoid receptor antagonists has the effect of blocking-up glucocorticoid receptor (GR), thereby has blocked the adverse effect that raises and caused because of the circulation cortisol levels.(McQUADE&YOUNG.British?Journal?of?Psychiatry，2000，Vol?177：P390)。
The Chinese patent ZL 99116829.1 of inventor's application discloses symipristone (Cymipristone) compounds and preparation method thereof, and this compounds is used to prepare the purposes of treatment and progestogen dependency diseases associated, antifertility, miscarriage or medicine aspects such as contraception, antitumor.
The symipristone compound that the present invention relates to be as shown in the formula steroidal compounds:
Wherein, R
1Be cyclopenta, cyclohexyl or suberyl, R
2Be hydrogen or C
1-C
6Alkyl, R
3Be hydrogen, C
1-C
6Alkyl or methylol, R
4Be hydrogen or hydroxy methylene (=CHOH).
The inventor finds that symipristone is a kind of novel glucocorticoid receptor antagonists.Pharmacological testing shows that symipristone is the same with mifepristone, all has the Antiglucocorticoid activity; Symipristone compound and glucocorticoid receptor (GR) have very strong affinity, and this kind affinity surpasses the affinity of mifepristone and glucocorticoid receptor (GR).The glucocorticoid antagonist that above-mentioned evidence symipristone is a kind of acceptor levels, can block the glucocorticoid receptor (GR) effect, can be used for repairing hpa axis negative feedback regulatory mechanism obstacle by the glucocorticoid receptor (GR) mediation, thereby treatment depression, particularly major depression, especially psychotic disease major depression.Finished the present invention thus.
Goal of the invention
The invention provides the purposes that symipristone compound is used to prepare treatment depression medicine.
Summary of the invention
The inventor discovers that symipristone compound can be used for the treatment of depression, particularly major depression, especially the psychotic disease major depression.The symipristone compound that the present invention relates to is a kind of known steroidal compounds, has following general formula (I):
Wherein, R
1Be cyclopenta, cyclohexyl or suberyl, R
2Be hydrogen or C
1-C
6Alkyl, R
3Be hydrogen, C
1-C
6Alkyl or methylol, R
4Be hydrogen or hydroxy methylene (=CHOH).
Chemical compound of the present invention can exist with salt form, and owing to wherein a plurality of asymmetric carbon atoms are arranged, this chemical compound can have a plurality of isomers, and these salt and isomer all belong to the claimed purposes scope of The compounds of this invention purposes.
Formula of the present invention (I) chemical compound is R wherein preferably
2Be hydrogen or methyl, R
3It is the chemical compound of methyl or methylol.
The preferred chemical compound of the present invention comprises:
11 β-[4-(N-methyl-N-cyclohexyl amino) phenyl]-17 α-(1-propinyl)-17 beta-hydroxies-4,9-estradiene-3-ketone, i.e. symipristone chemical compound.
The inventor discovers, symipristone compound and mifepristone compounds with, it is a kind of glucocorticoid receptor antagonists, effect with blocking-up glucocorticoid receptor (GR), can be used for the treatment of the disease that is produced because of the hpa axis negative feedback regulatory mechanism obstacle that is subjected to the glucocorticoid receptor (GR) mediation, for example can be used for the treatment of depression, particularly major depression, especially the psychotic disease major depression.
Therapeutic use of the present invention can be implemented by pharmaceutical compositions.Therefore, another aspect of the present invention provides a kind of depression that is used for the treatment of, major depression particularly, especially the pharmaceutical composition of psychosis major depression, this compositions can be with the form of solid preparations such as tablet, capsule, drop pill, granule, also can be with the form of liquid preparations such as injection, suspensoid, Emulsion, solution, can also also comprise the dosage form of special roles such as having slow release, controlled release, targeting, pulse accordingly with the form of various percutaneous drug administration preparations.
Description of drawings:
Fig. 1 is that symipristone, mifepristone are right
3H-DEX and the bonded competitive inhibition curve of Hepar Mus endochylema glucocorticoid receptor (GR) specificity.
Embodiment
Further specify the present invention below by embodiment, it should be understood that embodiments of the invention are to be used to illustrate the present invention rather than limitation of the present invention, essence according to the present invention all belongs to protection scope of the present invention to the improvement that the present invention carries out.
Embodiment 1: symipristone is to the detection of rats'liver endochylema glucocorticoid receptor (GR) adhesion
(1) test method
Female clean type SD rat, body weight 200～250 grams are quantitatively fed, and freely fetch water.Raising temperature is controlled at about 24 degree Celsius, and illumination is hours periods at 11 hours-nights 13 on daytime.All observed for 1 week before all laboratory animal experiments.
Bilateral otch under the arcus costarum of Mus dorsal part position is extractd rat bilateral adrenal gland, and postoperative is raised with normal saline and kept water-electrolyte balance.
The 3rd day acute execution animal in operation back taken out liver rapidly and places ice-cold buffer, cleans blood as far as possible.Get a certain amount of tissue and add buffer in 1: 4 ratio, and shred tissue, low temperature is the homogenate tissue intermittently, centrifugal 1 hour of 175000g, and it is standby to get supernatant.
Measure protein concentration in the supernatant, transfer protein concentration to 2mg/ml.
To be dissolved in alcoholic acid labelling, non-marked dexamethasone (DEX), symipristone, mifepristone and volatilize being at war with property inhibition experiment then in 37 ℃.
Competitive analysis: get the 0.2ml endochylema and add fixedly concentration H
3-dexamethasone adds variable concentrations and is tried thing (symipristone, mifepristone, dexamethasone) as tracer, hatches 24 hours for 4 ℃, with the DCC separated free with in conjunction with H
3-dexamethasone, cleer and peaceful precipitation radioactivity on the liquid flashing determining.
(2) date processing
RA (RBA): equaling 100% with the RBA of dexamethasone is standard, computing formula:
(3) result of the test
Competition suppresses experiment: each chemical compound is 16 * 10
-10～5 * 10
-7The mol/L concentration range can suppress H
3-dexamethasone (7.87nml/L) combines with rats'liver endochylema glucocorticoid receptor (GR), and its suppression ratio sees Table 1.Suppression ratio is converted into logit, and draws competition with each test-compound concentration logarithm log (mol/L) and suppress curve (Fig. 1).
Table 1. symipristone and mifepristone are to H
3The suppression ratio of-DEX receptors bind
(mean±SD，％，n＝4)
By the aforementioned calculation method, the receptor pharmacological property index of calculating each acceptor compound sees Table 2.
Table 2. symipristone and the comparison of mifepristone with the relative adhesion (RBA) of rats'liver endochylema glucocorticoid receptor (GR)
(mean±SD，n＝4)
Annotate: the adhesion with dexamethasone is 100 calculating
The RBA ratio of dexamethasone, symipristone and mifepristone is 1: 5.6: 3.4, IC
50Be respectively 14.50,2.60,4.21nmol/L, the IC of symipristone and mifepristone
50Than directly is 1.00: 1.62, shows that symipristone glucocorticoid receptor (GR) adhesion is better than mifepristone, can more effectively block glucocorticoid receptor (GR) than mifepristone, has the potentiality of stronger treatment depression.
Embodiment 2: the Antiglucocorticoid activity test
(1) test method
Female clean type SD rat, body weight 200～250 grams are quantitatively fed, and freely fetch water.Raising temperature is controlled at about 24 degree Celsius, and illumination is hours periods at 11 hours-nights 13 on daytime.All observed for 1 week before all laboratory animal experiments.
Use the etherization rat, bilateral otch under the Mus dorsal part arcus costarum, complete excision bilateral adrenal gland, postoperative is raised with normal saline.The 7th day acute execution animal, get thymus in the HBSS buffer, the washing secondary, and remove connective tissue, shred then, grind three layers of filtered through gauze, filtrate low-speed centrifugal 5 minutes (500 rev/mins) gently with homogenizer, sedimentation cell reuse HBSS washs secondary, with RPMI1640 culture fluid re-suspended cell, make cell counting and cell survival rate and measure, adjust cell concentration to 10
7/ ml.
The Antiglucocorticoid determination of activity: test-compound is added in the culture fluid, and making its reaction density is 6 * 10
-8～2 * 10
-6Mol/L, 37 ℃ of incubators preset 3 hours, added thymocyte cell then, made cell concentration reach 10
7/ ml, 37 ℃ of pre-cultivations 3 hours were cultivated 1 hour after adding 1 μ Ci label mixing again, added ice-cold 5% trichloroacetic acid, 100 μ l cessation reactions.Test tube is positioned on ice, uses ice-cold 2ml 5% trichloroacetic acid then, 500rpm * 5 minute centrifuge washing 2 times, sedimentation cell adds 1N NaOH 0.5ml, and dissolved cell is with the lysate sucking-off, with cotton swab residue is put on the skin driedly simultaneously, put in the same scintillation vial liquid flashing determining radioactivity.This test and Selection dexamethasone concentration 6 * 10
-8Detection Antiglucocorticoid activity, test-compound concentration are 6 * 10
-8～2 * 10
-6Mol/L.
(2) date processing
Calculate H
3-TdR incorporation efficiency:
Wherein, T is the H when not having chemical compound to exist
3The counting of-TdR, Td are the counting when having chemical compound to exist, and NSB is a non-specific adsorption.
Calculate symipristone Antiglucocorticoid activity according to formula, comprise H
3-TdR incorporation efficiency and remaining suppression ratio.Wherein dexamethasone concentration is 6 * 10
-8The time, remaining suppression ratio calculates with 100%.
Suppression ratio=100%-incorporation efficiency
(3) result of the test
Single with 6 * 10
-8During mol/L concentration dexamethasone, H
3-TdR incorporation efficiency is 43.2 ± 3.7%, and when merging the use test-compound, its effect is subjected to antagonism (table 3) in various degree.Shown that with remaining suppression ratio symipristone is in the performance (table 4) aspect the Antiglucocorticoid effect.
Table 3. symipristone and mifepristone are to the antagonism of dexamethasone effect
(Mean±SD，％，n＝4)
Table 4. symipristone and mifepristone are to the influence of the remaining suppression ratio of dexamethasone
(Mean±SD，％，n＝4)
Result of the test shows that symipristone and mifepristone all have the Antiglucocorticoid activity.
Embodiment 3: the preparation of drug combination preparation (tablet)
The prescription of tablet: symipristone 200 grams, pregelatinized Starch 10 grams, dextrin 20 grams, calcium sulfate 10 grams, microcrystalline Cellulose 10 grams, cross-linked pvp 14 grams, hypromellose 2.5 grams, magnesium stearate 3 grams (making 1000).
Took by weighing symipristone behind 80 mesh sieves, dextrin, starch, calcium sulfate, microcrystalline Cellulose etc. respectively by recipe quantity, above material was done mixed 20 minutes in the lump, add 2% hypromellose solution and make soft material in right amount, 14 mesh sieves are granulated, dry below 60 ℃, 14 mesh sieve granulate round the granule behind the grain, add magnesium stearate mix homogeneously tabletting promptly, every contains 200 milligrams of symipristones.
Embodiment 4: the preparation of drug combination preparation (capsule)
Capsular prescription: symipristone 200 grams, corn starch 20 grams, microcrystalline Cellulose 20 grams, hypromellose 2.5 grams, magnesium stearate 3 grams (making 1000 capsules).
Took by weighing symipristone, corn starch, microcrystalline Cellulose behind 80 mesh sieves respectively by recipe quantity, mixing, add 2% hypromellose solution and make soft material in right amount, 14 mesh sieves are granulated, dry below 60 ℃, 14 mesh sieve granulate add the magnesium stearate mix homogeneously, fill is in No. 1 capsule, and every capsules contains symipristone 200 Bos gram.
Claims (5)
1. formula (I) chemical compound is used to prepare the purposes of the medicine for the treatment of depression;
Wherein, R
1Be cyclopenta, cyclohexyl or suberyl, R
2Be hydrogen or C
1-C
6Alkyl, R
3Be hydrogen, C
1-C
6Alkyl or methylol, R
4Be hydrogen or hydroxy methylene.
2. according to the purposes of claim 1, wherein said depression is a major depression.
3. according to the purposes of claim 2, wherein said depression is the psychotic disease major depression.
4. according to the purposes of one of claim 1-3, wherein: R in formula (I) chemical compound
2Be hydrogen or methyl, R
3Be methyl or methylol.
5. according to the purposes of claim 4, its Chinese style (I) chemical compound is: 11 β-[4-N-methyl-N-cyclohexyl amino) phenyl]-17 α-(1-propinyl)-17 beta-hydroxies-4,9-estradiene-3-ketone.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN200410093036A CN100588393C (en) | 2004-12-15 | 2004-12-15 | Use of symipristone analog for treating depression |
| PCT/CN2005/002194 WO2006063526A1 (en) | 2004-12-15 | 2005-12-15 | Use of cymipristone for treating depression |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN200410093036A CN100588393C (en) | 2004-12-15 | 2004-12-15 | Use of symipristone analog for treating depression |
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| Publication Number | Publication Date |
|---|---|
| CN1788720A CN1788720A (en) | 2006-06-21 |
| CN100588393C true CN100588393C (en) | 2010-02-10 |
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|---|---|---|---|
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| WO (1) | WO2006063526A1 (en) |
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| CN102106805B (en) * | 2009-12-29 | 2013-06-12 | 上海中西制药有限公司 | Cymipristone solid preparation and preparation methods thereof |
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| CN1528315A (en) * | 1997-10-06 | 2004-09-15 | ������˹̹�������ѧ�й�ίԱ�� | Method for treating psychosis associated with cocaine addiction with glucocorticoid receptor antagonists |
| CN1117759C (en) * | 1999-09-02 | 2003-08-13 | 上海中西药业股份有限公司 | Steroid and its preparation method, medicine composition and application |
-
2004
- 2004-12-15 CN CN200410093036A patent/CN100588393C/en active Active
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| WO2006063526A1 (en) | 2006-06-22 |
| CN1788720A (en) | 2006-06-21 |
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